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What does trigeminy mean? Causes, symptoms, and treatment

By: Mohan Garikiparithi | Heart Health | Friday, September 15, 2017 - 06:00 AM

What is trigeminy?

Answering the question what is trigeminy can be difficult, but it is a term used in the field of cardiology, the study of the heart. Trigeminy refers to an irregular heartbeat or arrhythmia. Trigeminy may occur randomly or during specific intervals. The condition is more common in older individuals with underlying heart disorders such as coronary artery disease, mitral valve prolapse, and cardiomyopathy.

The rhythm of the heart is dictated by electrical impulses. These ensure the heart muscles contract efficiently enough to push the required amount of blood throughout the entire body. If the heart does not pump the necessary volume of blood, this can lead to various cardiac-related symptoms.

A trigeminy definition is as follows: it’s when there is a repetitive series of two normal heartbeats and one premature heartbeat. Every third heartbeat is said to be ectopic—starting from an area outside the sinus node that is normally responsible for setting the heart’s rhythm. This condition may also be called trigeminy PVC (premature ventricular contraction).

What are ventricular ectopic beats?

Ectopic rhythms may originate from many different parts of the heart and produce a premature heartbeat. Therefore, an ectopic beat may also be called a premature atrial contraction, premature ventricular contraction, or extrasystole.

The ventricles of the heart (the lower chambers) tend to be responsible for pumping the most blood due to their increased size and muscularity. An ectopic beat can result in the ventricles beating prematurely before normal depolarization has occurred. This is often represented on ECG (electrocardiogram) readings by wider and taller QRS complexes, which represent the activity of the ventricular muscles.

What are the causes and symptoms of trigeminy?

Trigeminy can occur in healthy individuals and at any age, but it is more common in older people and those suffering from some sort of cardiac disorder.

Major trigeminy causes involve some alteration in the function of the heart. This may include abnormal quantities of minerals and/or electrolytes in the bloodstream. Your body needs these substances for the proper functioning of cellular processes, including the operation of the heart and its rhythmic contractions. Low levels of minerals such as magnesium can lead to cardiac abnormalities, and they can be attributed to taking an excessive amount of diuretic medication.

Hormones may also influence heart function, such as when a rush of adrenaline leads to rapid heart rates. Sustained adrenaline can eventually interrupt the rhythm of the heart and contribute to the development of premature beats.

Increased stress levels and a lack of sleep can throw off the body’s metabolism and other processes. Stress can make your heart work overtime, potentially causing damage and irregular heart rhythms.

Causes of ventricular trigeminy may also include an underlying heart disorder or outside stimulation from various sources such as nicotine, alcohol, caffeine, certain medications, and certain illicit drugs like cocaine. Abnormal thyroid levels, inflammation, and reduced cardiac function as a result of age are also possible causes.

The signs and symptoms of trigeminy PVCs are the same as those of other kinds of arrhythmias. Trigeminy symptoms may include:

Lightheadedness
Palpitations (noticeable rapid heartbeat)
Fainting or passing out
Shortness of breath
Chest pain

Diagnosing trigeminy

When a heart condition is suspected, a full workup including medical history and a physical exam will be done. This will provide any additional clues that can be used as evidence for further testing. Additional tests for diagnosing trigeminy include:

Electrocardiogram (ECG/EKG): This test is used to measure electrical signals that are produced when the heart contracts. A normal pattern can be cross referenced to determine if the typical patterns of trigeminy are present.
Echocardiogram: This test uses sound waves to produce real-time images of the heart muscles. It can reveal thickened muscle tissue on the left ventricle, how the blood flows through the heart with each beat, and other cardiac features and abnormalities.
Magnetic resonance imaging (MRI): This test uses a sensitive imaging device that generates detailed pictures of the heart and reveals any abnormalities.
Treadmill stress test: This test is used to monitor the heart’s activity during exercise.
Cardiac catheterization/coronary angiography: This test looks directly at how narrow the heart vessels are.
Myocardial biopsy: This test collects a sample from the heart muscle to be analyzed.

How to treat trigeminy

If a trigeminy-induced arrhythmia is acute in nature and leads to a loss of consciousness, CPR and electroshock therapy (defibrillation) are the recommended emergency treatments. Once the condition is more manageable, the following trigeminy treatment recommendations may be made.

Lifestyle changes

To help lower your risk of complications, eat a healthy diet that is low in saturated fats, cholesterol, and sodium. Exercising in a manner that doesn’t excessively strain the heart will also help reduce your risk. It’s also recommended that you avoid smoking cigarettes and drinking excessive amounts of alcohol. The only way to preserve your heart health is to make these changes a part of your everyday life. Getting adequate amounts of sleep and reducing stress is also recommended.

Medications

Prescription heart medication can help reduce strain on the heart and prevent arrhythmias. Certain medications can also be used to improve heart function, depending on your particular circumstances. Cardiac medication may include:

Beta-blockers: These reduce blood pressure and heart rate
Calcium channel blockers: These relax and widen the arteries and lower blood pressure
Aldosterone inhibitors: These help lower blood pressure and aid in the elimination of edema (swelling caused by excess fluid)
Diuretics: These help to eliminate excess fluid and lower blood pressure, and they reduce the heart’s workload
Blood thinners: These help prevent the development of blood clots

Surgery and other procedures

In more severe cases of ischemic cardiomyopathy that cannot be controlled by medication alone, more invasive treatment methods are required. These may include: